Category: Drugs

Hi Dr Rassman
I’ve been taking propecia and minoxidil for about 3 months. Now i feel there is improvement in my hair. I am thinking of quiting minoxidil and use propecia only. Would i maintain my hair if i use propecia only. Thanks.

If the minoxidil gave you any improvement, stopping it would see those benefits disappear. Propecia will not maintain any minoxidil benefits for you (and vice versa). If the improvement you saw was from the Propecia, then stopping the minoxidil will be fine. Unfortunately, since you started both at the same time, the only way you’ll really know which medication was working is by stopping one and hoping you made the right choice.

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I’ve read that taking half a dose of propecia is not good because it is a time release drug and cutting it will release to much of the medicine at once. Is their any truth to this?

Propecia is not time released. Take it as directed. Recommended dosage is one pill daily. It’s actually quite simple. It has a half life of 4-6 hours and that means that each 4-6 hours, the dose circulating in the blood will reduce by half. Some of the drug gets into the tissue of the hair follicle and it may stay there for a few days (tissue fixation), so that is the reason you do not need a time release on the drug.

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Hello Dr.,

I’ve been reading through your blogs and took notice to a question posted by a Dr: Propecia Produces PMS in Men?

It appears that we are in the same situation as we get PMS symptoms w/ Propecia usage. My question is, if we are getting these side effects as a result of increased estrogen as a result of taking Propecia, is there a supplement or anything we could take or use to prevent/combat this from occurring. I, as everyone else here, want/feel I need to maintain my hair like you wouldn’t believe. It is important to note I have never gotten gyno from Propecia. I’m trying hard to get this figured out so I can utilize the only real proven hairloss fighter. Thanks so much, your help is greatly appreciated!

The post you are referring to is from one reader of BaldingBlog who is not my patient, nor do I have any sort of proof that he’s actually a physician as stated, not that it makes it any more plausible. I personally have never had a patient tell me they are having PMS-like emotional symptoms from taking Propecia, and combining my patient experience with the complete lack of information about it in the medical literature, I’d have to conclude the symptoms you experience are unrelated to Propecia use. I assume you’re just referring to the emotional symptoms of PMS and not the physical ones, too (such as cramping, bloating, etc). While it does not invalidate the symptoms from one such reader, I do not think it is really an issue for me to address, as it is all mostly theoretical.

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dear sir,thanks a lot for your kindness and great care about answering my questions. dr, can ketoconazole be taken systemically to treat seborrehic dermatitis?

There is a ketoconazole oral, but it has huge warnings about liver problems that can sometimes be fatal. That being said, ketoconazole is an antifungal medication… and to treat seborrheic dermatitis (dandruff), you would probably be better off with a shampoo.

how does DHT inhibiters impact other organ function?

I found an interesting article that discusses that very question in the Journal of Urology, published in June 2008. Rather than re-write an answer that has already been given, I’ll just post part of the abstract from the article –

“Profound suppression of circulating serum dihydrotestosterone induced by 5alpha-reductase inhibitors during 1 year does not adversely impact bone, serum lipoproteins or hemoglobin, and has a minimal, reversible effect on serum prostate specific antigen and sexual function in normal men. Circulating dihydrotestosterone does not appear to have a clinically significant role in modulating bone mass, hematopoiesis or lipid metabolism in normal men.”

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Hi Doctor Rassman

i been considering to take dutasteride for my hair loss . I been taking proscar for more than a year and seems that there is no improvement in my condition.There are many good report that dutasteride works much better than finasteride and soem of the people i know also have good result from it but from what you say, dutaseride may cause sterility in future.I can’t find any report on this.Can you please specify why will it cause sterility?And i understand that all side effects will stop once you stop taking the pills and that there are no permanent side effects.Please correct me if i am wrong as now the only concern that is stopping me from taking dutasteride is what you say about sterility.Appreciate your reply.Thanks

Regards

I really have no opinion of my own when it relates to dutasteride, as I’m still waiting for some kind of assurance from the FDA that this medication won’t cause sterility problems. I’m trying to find clinical reference, and while there might be more out there, one that I found referenced was published in the Journal of Clinical Endocrinology and Metabolism back in 2005. Although that study was not long term and was mainly about steroids, one of the study groups included dutasteride (although it was taken with other drugs) and indicated temporary sterility. I realize this isn’t a perfect example, and I’ll try to dig up some other studies one way or the other, as this is something that needs to be addressed.

I’m also concerned that the most recent Korean clinical trial didn’t reference sterility at all, positive or negative (I just wrote about this). Keep in mind that we want the FDA to clear this medication for hair loss treatment and address this potential problem in its review.

This isn’t hair-related, but it is quite interesting and may have applicability to many of you. After you review it, you might want to talk with your doctor about this subject.

Abstract from the study:

The use of statins is widespread and many patients presenting for surgery are regularly taking them. There is evidence that statins have beneficial effects beyond those of lipid lowering, including reducing the perioperative risk of cardiac complications and sepsis. This review addresses the cellular mechanisms by which statins may produce these effects. Statins appear to have actions on vascular nitric oxide through the balance of inducible and endothelial nitric oxide synthase. The clinical evidence for these benefits is also briefly reviewed with the objective of clarifying the current status of statin use in the perioperative period. There is reasonably strong evidence that patients already taking statins should continue on them perioperatively. However, the evidence for the prophylactic use of statins perioperatively is weak and lacks prospective controlled studies.

Read the full text — Statins for All: The New Premed?

For years, I have been taking statins even with a normal cholesterol level. Many people who die of heart disease have normal cholesterol. Today’s regular Western diet may not be good for your health and as my father died from heart disease, the genes are there in my family line. Unfortunately, sudden death is often the first sign of heart disease (in 70% of those who have a heart attack). Although this article points to the risks associated with anesthetic risks and ways of mitigating them, my feeling is that there is a great value to taking a statin drugs routinely.